Wyniki wyszukiwania - Biblioteka Nauki

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Cochlear Implantation in Children with Congenital Inner Ear Malformations

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Abbas A. M. , Hamed M. S. , Ahmed A. S.

Polski Przegląd Otorynolaryngologiczny

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2022

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tom 11

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nr 4

1-12

EN

Introduction: Cochlear Implantation has proven beneficial in patients with profound congenital hearing impairments. Performing cochlear implantation in patients with inner ear malformation has always been a matter of dispute as congenitally deaf ears may have anatomical malformations and thus meet difficulties during operation. Therefore, it is important to focus on problems and complications encountered by surgeons performing such operations. Aim: To evaluate problems and surgical difficulties encountered in patients with congenital inner ear malformation, who underwent cochlear implantation. Material and methods: A series of 21 pediatric cochlear implant (CI) patients with known inner ear malformations determined on computed tomography (CT) of the temporal bone who underwent cochlear implantation in the Department of Otolaryngology of Martyr Ghazi Al-Hariri and AL-Yarmouk Teaching Hospital, Baghdad, Iraq, from January 2018 to January 2021. The study aimed to determine intraoperative adverse effects of these anomalies regarding electrode array insertion depths, predisposition to cerebrospinal fluid (CSF) leak through the cochleostomy, and associated facial nerve anomalies that can create problems with access to scala tympani. Results: The most common inner ear anomalies were wide vestibular aqueduct (15 patients, which makes 71.4%), incomplete partitions (5 patients, 23.8%), and common cavity (1 patient, 4.8%). As concerns CSF leak, the most common was CSF ooze (11 patients, 52.4%), CSF gusher (6 patients, 28.6%), and no CSF leak (4 patients, 19%). Among facial nerve anomalies there was only one case (4.8%) of abnormal position (more superficial and not injured) and 20 cases (95.2%) in which no anomaly was detected. As concerns electrode insertion depth, full insertion was achieved in 17 patients (81%), while incomplete insertion in 4 patients (19%). Conclusion: Cochlear implant can be successfully and safely inserted in patients with selected congenital inner ear anomalies. Surgery can be challenging in certain cases of gusher and facial nerve abnormalities, but proper radiology and good surgical technique will help avoid complications.

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Current indications for cochlear implantation in adults and children

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Szyfter W. , Karlik M. , Sekula A. , Harris S. , Gawęcki W.

Polish Journal of Otolaryngology

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2019

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tom 73

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nr 3

1-5

EN

Introduction: Surgical treatment of deafness by cochlear implants is used for more than 40 years, and during this period permanently, gradual and significant expansion of indications for this surgery has been observed. Material and methods: In our Department in the years 1994-2018 1480 cochlear implantations were performed, both in adults (647) and in children (883). In this study current indications and the rules for eligibility of patients based on 25 years of experience are presented. Results: Indications for cochlear implantation in adults are: 1) bilateral postlingual deafness, 2) bilateral sensorineural hearing loss - in pure tone audiometry > 70 dB HL (average 500-4000 Hz) and in speech audiometry in hearing aids understanding < 50% of words for the intensity of the stimulus 65 dB, in the absence of the benefits of hearing aids, 3) bilateral profound hearing loss for high frequency with good hearing for low frequency, in the absence of the benefits of hearing aids, 4) some cases of asymmetric hearing loss with intensive tinnitus in the deaf ear. An indication in children is bilateral sensorineural hearing loss > 80dB HL confirmed by hearing tests, after about 6 months of rehabilitation with the use of hearing aids. Discussion: Although cochlear implantation is used for more than 40 years, the indications for this treatment underlies constant modifications. They concern the age of eligible patients, implantation in patients with partially preserved hearing, as well as treatment for patients with difficult anatomical conditions. In many countries, bilateral implantations are commonly performed, and more and more centers recommend this treatment in the case of unilateral deafness or asymmetric hearing loss, especially with the accompanying tinnitus in the deaf ear.

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Diagnoza i etapy rehabilitacji pacjenta po wszczepieniu implantatu ślimakowego

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Kasica B. , Kasica-Bańkowska K.

Logopedia Silesiana

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2013

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nr Logoepdia Silesiana nr 2

161-167

EN

Cochlear implants (CI) are surgically implanted electronic devices that enable individuals who are profoundly deaf to hear. It should be pointed out that a surgically implanted device does not provide a sense of sound totally . It does allow the deaf to recognize sounds and help to understand speech. However, after placing a cochlear implant the quality of sound is different from natural hearing and takes time to learn and recognize the memory signs. The article consists of preliminary diagnosis and stages of patient rehabilitation before and after placing CI.

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The topographical anatomy of the round window and related structures for the purpose of cochlear implant surgery

75%

Paprocki A. , Biskup B. , Kozlowska K. , Kuniszyk A. , Bien D. , Niemczyk K.

Folia Morphologica

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2004

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tom 63

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nr 3

EN

The treatment of total deafness using a cochlear implant has now become a routine medical procedure. The tendency to expand the audiological indications for cochlear stimulation and to preserve the remnants of hearing has brought new problems. The authors have studied the topographical anatomy of the internal structures of the ear in the area where cochleostomy is usually performed and an implant electrode inserted. Ten human temporal bones were obtained from cadavers and prepared in a formalin stain. After dissection of the bone in the area of round and oval windows, the following diameters were measured using a microscope with a scale: the transverse diameters of the cochlear and vestibular scalae at the level of the centre of the round window and 0.5 mm anteriorly to the round window, the distance between the windows and the distances from the end of the spiral lamina to the centre of the round window and to its anterior margin. The width of the cochlear scala at the level of the round window was 1.23 mm, and 0.5 mm anteriorly to the round window membrane it was 1.24 mm. The corresponding diameters for the vestibular scala are 1.34 and 1.27 mm. The distances from the end of the spiral lamina to the centre of the round window and to its anterior margin are 1.26 and 2.06 respectively. The authors noted that the two methods of electrode insertion show a difference of 2 mm in the length of the stimulated spiral lamina. The average total length of the unstimulated lamina is 2.06 and 4.06 in the two situations respectively.